Provider Demographics
NPI:1689655185
Name:STEWART, CARRIE J (MD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:J
Last Name:STEWART
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:46325 W 12 MILE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377
Mailing Address - Country:US
Mailing Address - Phone:877-784-3667
Mailing Address - Fax:248-869-3982
Practice Address - Street 1:46325 W 12 MILE RD
Practice Address - Street 2:STE 100
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377
Practice Address - Country:US
Practice Address - Phone:877-784-3667
Practice Address - Fax:248-869-3982
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2015-03-11
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Provider Licenses
StateLicense IDTaxonomies
MI4301080187208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
0Q26462088Medicare PIN